Carpal Tunnel Syndrome Research Paper
Carpus is a word derived from the Greek word karpos, which means "wrist." The wrist is surrounded by a band of fibrous tissue that normally functions as a support for the joint. The tight space between this fibrous band and the wrist bone is called the carpal tunnel. The median nerve passes through the carpal tunnel to receive sensations from the thumb, index, and middle fingers of the hand. Any condition that causes swelling or a change in position of the tissue within the carpal tunnel can squeeze and irritate the median nerve. Irritation of the median nerve in this manner causes tingling and numbness of the thumb, index, and the middle fingers - a condition known as "carpal tunnel syndrome." This term was first used in 1939, but the scientists
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had started to investigate the problem only in the 1960s when a number of serious researches dedicated to this disease were held. Problems that can occur in carpal tunnel syndrome include: * Pain * Numbness * Tingling * Weakness Shiel (2010) writes that for most patients, the cause of their carpal tunnel syndrome is unknown, but there are several conditions that can cause the syndrome – obesity, pregnancy, arthritis, diabetes and trauma.
Tendon inflammation resulting from repetitive work, such as uninterrupted typing, can also cause carpal tunnel symptoms. Carpal tunnel syndrome from repetitive maneuvers has been referred to as one of the repetitive stress injuries. Some rare diseases can cause deposition of abnormal substances in and around the carpal tunnel, leading to nerve irritation. These diseases include amyloidosis, sarcoidosis,multiple myeloma, and …show more content…
leukemia.
What are the main carpal tunnel syndrome symptoms? People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and part of the fourth fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress. Cluett (2010) states that there is one common symptom of carpal tunnel syndrome: people find shaking the hand often relieves these symptoms.
Pain may extend up the arm, and the pain from carpal tunnel syndrome is often worst at night. Often patients find they are awakened at night, and have to shake out their hand to get the tingling in their fingers to resolve. Other activities including driving and typing can aggravate symptoms of carpal tunnel syndrome.
| Picture of carpal tunnel syndrome |
As the disease progresses, patients can develop a burning sensation, and/or cramping and weakness of the hand. Decreased grip strength can lead to frequent dropping of objects from the hand. Occasionally, sharp shooting pains can be felt in the forearm. Chronic carpal tunnel syndrome can also lead to wasting (atrophy) of the hand muscles, particularly those near the base of the thumb in the palm of the hand. There are a few ways of how the carpal tunnel syndrome can be discovered. These are actually three different tests used to prove the symptoms. * Tinel's Sign
Tinel's test is performed by tapping the median nerve along its course in the wrist. A positive test is found when this causes worsening of the tingling in the fingers when the nerve is tapped. * Phalen's
Sign
Phalen's test is done by pushing the back of your hands together for one minute. This compresses the carpal tunnel and is also positive when it causes the same symptoms you have been experiencing with your carpal tunnel syndrome. * Durkan test, carpal compression test, or applying firm pressure to the palm over the nerve for up to 30 seconds to elicit symptoms has also been proposed. Ashworth (2008) writes that carpal tunnel syndrome is very widespread and nobody can be protected from it. In the U.S., roughly 1 out of 20 people will suffer from the effects of carpal tunnel syndrome. Caucasians have the highest risk of CTS compared with other races such as non-white South Africans. Women suffer more from CTS than men with a ratio of 3:1 between the ages of 45–60 years. Only 10% of reported cases of CTS are younger than 30 years. Many of the experts agree that healthy way of life and the use of ergonomic equipment (mouse pads, keyboards and other) can help to lessen the stress and avoid the syndrome development. The syndrome can be treated in two ways: using the palliative methods (corticosteroid injections, immobilizing braces, ultrasound treatment and other alternatives) or using carpal tunnel release surgery (there are two common techniques used).
Carpal Tunnel Syndrome Operation Hui (2004) states that the surgery is recommended when there is static (constant, not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting no longer controls intermittent symptoms. In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and are likely to result in surgical treatment. In carpal tunnel release surgery, the goal is to divide the transverse carpal ligament in two. This is a wide ligament that runs across the hand, from the scaphoid bone to the hamate bone and pisiform. It forms the roof of the carpal tunnel, and when the surgeon cuts across it (i.e., in a line with the ring finger) it no longer presses down on the nerve inside, relieving the pressure. The two major types of surgery are open carpal tunnel release and endoscopic carpal tunnel release. Most surgeons historically have performed the open procedure, widely considered to be the gold standard. However, since the 1990s, a growing number of surgeons now offer endoscopic carpal tunnel release. The alternative surgery methods offer direct access to the median nerve and shorter recovery time. About 90% of the disease cases are cured successfully. The patients usually recover comparatively soon from the consequences of the carpal tunnel syndrome. However, the long lasting stress caused to the nerve may have serious negative impact on the hand’s sensitiveness and power long after the treatment is complete. In this case the patients use special exercises worked out to help the arm to be fit and get into better condition.
Sources
Ashworth, N. (2008). Carpal tunnel syndrome. eMedicine portal. Available at http://emedicine.medscape.com/article/327330-overview Cluett, J. (2010). Carpal tunnel syndrome. Available at http://orthopedics.about.com/cs/carpaltunnel/a/carpaltunnel_2.htm Chow, J; Hantes, M. (2002). Endoscopic carpal tunnel release: Thirteen years' experience with the chow technique. The Journal of Hand Surgery 27 (6): 1011–8
Hui, A. (2004). "Long-term outcome of carpal tunnel syndrome after conservative treatment. International Journal of Clinical Practice58 (4): 337–9.
Scott, K., Kothari, M. (2009). Treatment of carpal tunnel syndrome. Available at http://www.uptodate.com/contents/treatment-of-carpal-tunnel-syndrome Shiel, W. (2010). Carpal tunnel syndrome. Available at http://www.medicinenet.com/carpal_tunnel_syndrome/article.htm What is carpal tunnel syndrome? Video at
http://video.about.com/ergonomics/Carpal-Tunnel-Syndrome.htm
had started to investigate the problem only in the 1960s when a number of serious researches dedicated to this disease were held. Problems that can occur in carpal tunnel syndrome include: * Pain * Numbness * Tingling * Weakness Shiel (2010) writes that for most patients, the cause of their carpal tunnel syndrome is unknown, but there are several conditions that can cause the syndrome – obesity, pregnancy, arthritis, diabetes and trauma.
Tendon inflammation resulting from repetitive work, such as uninterrupted typing, can also cause carpal tunnel symptoms. Carpal tunnel syndrome from repetitive maneuvers has been referred to as one of the repetitive stress injuries. Some rare diseases can cause deposition of abnormal substances in and around the carpal tunnel, leading to nerve irritation. These diseases include amyloidosis, sarcoidosis,multiple myeloma, and …show more content…
leukemia.
What are the main carpal tunnel syndrome symptoms? People with carpal tunnel syndrome initially feel numbness and tingling of the hand in the distribution of the median nerve (the thumb, index, middle, and part of the fourth fingers). These sensations are often more pronounced at night and can awaken people from sleep. The reason symptoms are worse at night may be related to the flexed-wrist sleeping position and/or fluid accumulating around the wrist and hand while lying flat. Carpal tunnel syndrome may be a temporary condition that completely resolves or it can persist and progress. Cluett (2010) states that there is one common symptom of carpal tunnel syndrome: people find shaking the hand often relieves these symptoms.
Pain may extend up the arm, and the pain from carpal tunnel syndrome is often worst at night. Often patients find they are awakened at night, and have to shake out their hand to get the tingling in their fingers to resolve. Other activities including driving and typing can aggravate symptoms of carpal tunnel syndrome.
| Picture of carpal tunnel syndrome |
As the disease progresses, patients can develop a burning sensation, and/or cramping and weakness of the hand. Decreased grip strength can lead to frequent dropping of objects from the hand. Occasionally, sharp shooting pains can be felt in the forearm. Chronic carpal tunnel syndrome can also lead to wasting (atrophy) of the hand muscles, particularly those near the base of the thumb in the palm of the hand. There are a few ways of how the carpal tunnel syndrome can be discovered. These are actually three different tests used to prove the symptoms. * Tinel's Sign
Tinel's test is performed by tapping the median nerve along its course in the wrist. A positive test is found when this causes worsening of the tingling in the fingers when the nerve is tapped. * Phalen's
Sign
Phalen's test is done by pushing the back of your hands together for one minute. This compresses the carpal tunnel and is also positive when it causes the same symptoms you have been experiencing with your carpal tunnel syndrome. * Durkan test, carpal compression test, or applying firm pressure to the palm over the nerve for up to 30 seconds to elicit symptoms has also been proposed. Ashworth (2008) writes that carpal tunnel syndrome is very widespread and nobody can be protected from it. In the U.S., roughly 1 out of 20 people will suffer from the effects of carpal tunnel syndrome. Caucasians have the highest risk of CTS compared with other races such as non-white South Africans. Women suffer more from CTS than men with a ratio of 3:1 between the ages of 45–60 years. Only 10% of reported cases of CTS are younger than 30 years. Many of the experts agree that healthy way of life and the use of ergonomic equipment (mouse pads, keyboards and other) can help to lessen the stress and avoid the syndrome development. The syndrome can be treated in two ways: using the palliative methods (corticosteroid injections, immobilizing braces, ultrasound treatment and other alternatives) or using carpal tunnel release surgery (there are two common techniques used).
Carpal Tunnel Syndrome Operation Hui (2004) states that the surgery is recommended when there is static (constant, not just intermittent) numbness, muscle weakness, or atrophy, and when night-splinting no longer controls intermittent symptoms. In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and are likely to result in surgical treatment. In carpal tunnel release surgery, the goal is to divide the transverse carpal ligament in two. This is a wide ligament that runs across the hand, from the scaphoid bone to the hamate bone and pisiform. It forms the roof of the carpal tunnel, and when the surgeon cuts across it (i.e., in a line with the ring finger) it no longer presses down on the nerve inside, relieving the pressure. The two major types of surgery are open carpal tunnel release and endoscopic carpal tunnel release. Most surgeons historically have performed the open procedure, widely considered to be the gold standard. However, since the 1990s, a growing number of surgeons now offer endoscopic carpal tunnel release. The alternative surgery methods offer direct access to the median nerve and shorter recovery time. About 90% of the disease cases are cured successfully. The patients usually recover comparatively soon from the consequences of the carpal tunnel syndrome. However, the long lasting stress caused to the nerve may have serious negative impact on the hand’s sensitiveness and power long after the treatment is complete. In this case the patients use special exercises worked out to help the arm to be fit and get into better condition.
Sources
Ashworth, N. (2008). Carpal tunnel syndrome. eMedicine portal. Available at http://emedicine.medscape.com/article/327330-overview Cluett, J. (2010). Carpal tunnel syndrome. Available at http://orthopedics.about.com/cs/carpaltunnel/a/carpaltunnel_2.htm Chow, J; Hantes, M. (2002). Endoscopic carpal tunnel release: Thirteen years' experience with the chow technique. The Journal of Hand Surgery 27 (6): 1011–8
Hui, A. (2004). "Long-term outcome of carpal tunnel syndrome after conservative treatment. International Journal of Clinical Practice58 (4): 337–9.
Scott, K., Kothari, M. (2009). Treatment of carpal tunnel syndrome. Available at http://www.uptodate.com/contents/treatment-of-carpal-tunnel-syndrome Shiel, W. (2010). Carpal tunnel syndrome. Available at http://www.medicinenet.com/carpal_tunnel_syndrome/article.htm What is carpal tunnel syndrome? Video at
http://video.about.com/ergonomics/Carpal-Tunnel-Syndrome.htm